Question from a reader:
Is it true that the longer you’re on suboxone the harder and worse it is to get off it? My belief is long term treatment outweighs the benefits of short term treatment, people who do “the short term” detox ALWAYS seem to relapse…
I try to talk to people about this at a site/forum i just recently left because of the false and inaccurate information given on a daily basis from people who have never been on suboxone treatment…? i got tired of arguing my point, and tired of defending my recovery…so i left!
Recovery dot com is a mess there for anyone on suboxone treatment looking for support. I am in NO WAY promoting this forum for anyone looking for support…its just awful. its was 80% of my problem related to depression.
I started suboxone treatment in May of 2007, and i feel fine. i am not using, i feel nothing but normalcy. something i hadnt felt in almost 10 years.
Suboxone and the work i put into this literally saved my life, and gave me a 2nd chance at life.
Answer:
As you probably know. the answer to your question is no– there is absolutely no evidence that it gets harder and harder to get off Suboxone. From an understanding of how Suboxone works, there is no reason to suspect that would be true, whether looking from the neurochemical perspective or the behavioral perspective.
Neurochemically, Suboxone induces a certain level of tolerance that remains constant over time; a person’s tolerance after a few days of Suboxone will be the same as after ten years of Suboxone. I can also assure you from witnessing many people stopping Suboxone that it is MUCH EASIER to come off than it is to come off an opiate agonist like hydrocodone, oxycodone, or methadone. Sites that say otherwise are either lying or ignorant.
From a behavioral perspective, the goal with Suboxone treatment is to ‘extinguish conditioned behavior’. Think of a dog trained to push a lever for a pellet of food; if you stop giving the pellet, the dog will push the lever over and over for awhile, then go lay down and sleep… then wake up, come back, and push the lever over and over again… eventually giving up. The dog’s automatic conditioned behavior, that ‘lever means pellet’, eventually goes away.
The addict on Suboxone needs the same thing to happen with the conditioned behavior related to addiction. This is why it is so important to dose once per day in the morning and to ignore those little feelings late in the day that feel like withdrawal, but that in reality are just in your mind. Those feelings are remnants of conditioning; if a person distracts himself and ignores them they will eventually fade away and the person will ‘forget’ he is an addict entirely!
On the other hand, if he takes a bit of extra Suboxone for those feelings he will only reinforce them– sort of like giving a pellet to the dog every now and then, just when it is about to give up on pushing the lever. The best way to take Suboxone is to NEVER take it in response to a ‘feeling that it is needed’; that is what using addicts do when they abuse Suboxone. Instead you want to take it in the morning automatically, without feeling that it is needed to change how you feel.
I agree that Suboxone is best thought of and used as a long-term medication. As for those sites that you mentioned and others like them, I don’t know why they have such a following. One thing I know though from 15 years of Recovery and meetings– the type of fear-mongering in bitterness that is spread by those sites is not consistent with staying sober– not for long anyway. I suggest we all just let those people be.
2 Comments
Amy · October 23, 2008 at 11:08 am
I want to thank you SO much for answering my question…you explained a lot to me. as of now i do not have any plans of getting off suboxone as i do have legitimate pain issues and i fear going back to the narcotics for pain relief, i KNOW how that would end. which leads to my next question …i DO take my suboxone twice daily, and there have been times i have taken more when in a flare up to try to lesson my pain…am i doing myself a dis-service by doing this? should i go to taking it once daily?
i originally started taking it twice a day when i transitioned from methadone to suboxone, which was hell, but the once a day dose wasnt holding me, i was waking up in withdrawals by 2 am in the morning, so my sub doc told me to take it twice daily…that was now quite a while ago, should i try to get to once a day doseing, would it be better for my addiction to dose once a day???
by the way, i LOVE this place!!! the most truly informative, honest, expert advice with experience for anyone thinking of suboxone treatment or currently on suboxone treatment…GREAT PLACE!! and i thank you!
Logan25 · July 30, 2010 at 12:14 am
I completely agree. It’s astonishing also when you hear many people’s suggested regimens for replacing Suboxone, which including SSRI’s and even benzos sometimes. So, give up this daily pill that works for a cocktail of daily pills that will somewhat but not really work, and with worse side effects. Withdrawl from SSRI’s can be hell too.
What’s the real problem people have with Suboxone? I can’t help but think for some people it’s perhaps exactly that it does work. Some are resentful of that. They think you should be doing the “real work” of sobriety. Of course by real work they mean suffering.
Now there IS often something to be gained through suffering, all things being isolated and equal which they never are. First of all, all this character building happens over a long period of time within a relatively short life we all are endowed with. There’s also the pesky 90/10 problem with relapse, which probability-wise means you can very easily spend almost your whole life suffering and relapsing. You might finally kick for good just in time to trade your painkillers for antidepressants one last time, and then for Viagra soon after. But hey, you’re drug free (for really real, no backsies).
It’s all just a label anyway, and addiction isn’t defined which labels are on your pill bottles.